Before and after bilateral DIEP flap breast reconstruction in a 52-year-old breast cancer survivor who had a previous right failed implant reconstruction. Following bilateral non-skin-sparing mastectomies, chemotherapy and right chest wall radiation for invasive breast cancer, she sought breast reconstruction. Her right implant required removal due to exposure through the skin after an infection.
Given her body shape and abundant lower abdominal skin and fat, she was an ideal candidate for a microvascular reconstruction using the deep inferior epigastric artery perforator flap. Her left implant was removed, and bilateral DIEP flaps were transplanted from the lower abdomen to the chest. One tiny artery and two tiny veins were anastomosed (disconnected and then reconnected under the microscope) for each free flap.
A secondary revision procedure involved nipple and areola reconstruction using local flaps and medical tattoo, liposuction contouring of her bra rolls, abdomen and flanks, free fat grafting to the upper pole of her flaps, abdominal scar revisions and removal of her left chest chemotherapy port.
Follow up photos are shown 4 years after surgery. She expressed that she has been able to “move forward” after her breast cancer treatments and is grateful that she had the opportunity to have microsurgery for her breast reconstruction, which she views as much as a makeover as a reconstructive procedure.
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
